探討加護病房護理人員工作負荷與逾時下班之關係－以南部某醫學中心為例

The Relationship Between Workload and Overtime in Intensive Care Unit Nurse - A Case Study of a Medical Center in Southern Taiwan

莊孟蓉(Meng-Jung Chuang)；蔣佳綺(Chia-Chi Chiang)；陳琮琳(Chuang-Lin Chen)；賴昭翰(Chao-Han Lai)

加護病房 ； 護理照護活動 ； 逾時下班 ； 周轉率 ； intensive care unit ； nursing activities ； overtime ； turnover rate

志為護理-慈濟護理雜誌

17卷4期（2018 / 08 / 01）

63 - 75

繁體中文

目的：了解影響加護病房護理師延遲下班與照護活動之因素，並比較照護活動工時差異。方法：以直接觀察及臨床工作分析法進行內、外、綜合科三個加護病房護理照護活動測量，透過實際觀察及紀錄護理師之照護活動與時間分配。結果：(一)加護病房照護活動，直接護理與逾時成負相關（r =- .378, p ＜.05），相關護理與逾時成正相關（r = .417, p ＜ .05）。(二)綜合ICU的相關護理和周轉率較高，其逾時時間明顯大於外科及內科ICU（F = 15.16, p ＜ .05）。(三)周轉率是可以預測護理人員逾時，週轉率與逾時成正相關（r = .454, p ＜ .05），解釋變異量為20.6%。結論/實務應用：各病房應該依單位屬性，特別是相關護理與周轉率高的單位，應適當調整及考量人力與工作分配，以降低逾時下班。

Purpose: To understand the influences of nursing activities on overtime in intensive care unit (ICU) nurses, and to compare the differences of these nursing activities on their working hours. Methods: Nursing activities in medical, surgical, and general ICU were measured using direct observation and clinical task analysis, and the nursing activities of ICU nurses and time allocation were directly observed and recorded. Results : (1) In regards to nursing activities in ICU, direct nursing was negatively correlated with overtime (r =- .378, p＜ .05), and indirect nursing care is positively correlated overtime (r = .417, p ＜ .05); (2) indirect nursing and turnover rate in general ICU is higher than medical and surgical ICU, with significantly longer overtime (F =5.16, p ＜ .05) than the other ICUs; (3) Turnover rate is a predictor of nurse overtime, and is positively correlated with overtime (r = .454, p ＜ .05), with an explained variation of 20.6%. Conclusion / practical application: To reduce staff overtime, staff and task allocation for each ward should be appropriately regulated, taking into consideration the nature of each unit, particularly units that are related to nursing and have exhibited a high turnover rate in the past.

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